13.8:
Respiratory Assessment: Purpose and Indications
The respiratory assessment is fundamental to the nursing assessment and must be a priority area of skill development.
The purpose of this assessment is to identify patients at risk of deterioration. Breathing is generally the first vital sign that varies in a deteriorating patient.
A respiratory assessment helps plan and start appropriate treatment to stabilize and enhance the patient's condition and outcomes and aids in preventing an unnecessary admission to critical care units.
A respiratory assessment should be performed and recorded regularly for all patients in the hospital. It must be carried out following surgery, procedures, trauma, or emergencies to compare and recognize any changes in baseline data.
In addition, conducting and recording the respiratory assessment before, during, and after the transfusion of blood or blood products is imperative.
These assessments are also performed before and during the administration of certain medications like opiates and bronchodilators to observe the patient's response to medications.
Finally, a respiratory assessment is necessary for the patient receiving oxygen therapy to ensure its efficacy.
13.8:
Respiratory Assessment: Purpose and Indications
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a key indicator of potential problems and must be monitored vigilantly. Early recognition of these signs allows nurses to initiate timely interventions, potentially preventing the escalation of adverse events.
Comprehensive Evaluation:
A thorough respiratory assessment involves more than observing respiratory rates and sounds; it includes:
- • Inspection: Observing the chest for symmetry, effort, and use of accessory muscles.
- • Palpation: Assessing for tenderness, deformities, or abnormal movements.
- • Percussion: Determining the underlying lung and pleural space conditions.
- • Auscultation: Listening to breath sounds to identify abnormalities such as wheezes, crackles, or diminished breath sounds.
This comprehensive approach helps formulate a precise clinical picture. It guides the development of an appropriate treatment plan, enhancing patient outcomes and optimizing healthcare resources by potentially reducing unnecessary intensive care admissions.
Systematic Recording:
Regular and systematic documentation of respiratory assessments is essential, particularly after surgical procedures, trauma, or medical emergencies where vigilant monitoring of baseline respiratory changes is crucial. This practice is vital for detecting complications early and initiating prompt medical interventions.
Critical Moments for Assessment:
Respiratory evaluation is also vital:
- • Before, during, and after the transfusion of blood products to monitor for adverse reactions.
- • When administering medications like opiates and bronchodilators, which can significantly impact respiratory dynamics. This ensures that therapeutic interventions are adapted to the patient’s changing needs.
- • During oxygen therapy, the delivery should be adjusted according to fluctuating patient requirements, ensuring the treatment remains effective and safe. As a result, complications associated with both hypoxemia and hyperoxia should be prevented.
Conclusion:
In nursing practice, the respiratory assessment is not just a task but a fundamental component of patient-centered care. Its systematic application is vital for the early detection of respiratory compromise, allowing for timely and targeted interventions. Through their diligent assessment and intervention, nurses play a crucial role in safeguarding patient health, underscoring the significance of this skill in nursing.